老年慢性肾脏病患者骨代谢指标与心脑血管疾病发生的相关性  

Correlation between bone metabolism indexes and cardiovascular and cerebrovascular diseases in elderly patients with chronic kidney disease

作　　者：韩晓霞 赵志杰 李鹏飞 刘青 HAN Xiaoxia;ZHAO Zhijie;LI Pengfei;LIU Qing(Department of Clinical Laboratory,Cangzhou People’s Hospital,Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北省沧州市人民医院检验科,河北沧州061000

出　　处：《中国医药导报》2024年第15期63-66,共4页China Medical Herald

基　　金：河北省医学科学研究课题计划项目(20220323)。

摘　　要：目的 分析慢性肾脏病(CKD)患者骨代谢指标与心脑血管疾病发生的相关性,为降低心脑血管疾病发生提供新手段。方法 收集2022年10月至2023年4月河北省沧州市人民医院老年科住院治疗的老年CKD患者160例为研究对象,根据是否合并心脑血管疾病将其分为对照组(80例,未合并心脑血管疾病)和病例组(80例,合并心脑血管疾病)。比较两组临床资料,采用Pearson分析骨代谢指标与心脑血管疾病发生的相关性,采用多因素logistic回归分析老年CKD患者发生心脑血管疾病的影响因素。结果 两组年龄、性别、体重指数、CKD分期及CKD病程比较,差异无统计学意义(P>0.05)。病例组曾经或正在吸烟和饮酒的患者比例大于对照组,病例组甘油三酯(TG)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平均高于对照组(P<0.05),病例组高密度脂蛋白胆固醇(HDL-C)水平低于对照组(P<0.05)。病例组血清中25-羟维生素D_(3)[25-(OH)D_(3)]、β-Ⅰ型胶原C-末端肽交联(β-CTX)和抗酒石酸酸性磷酸酶5b(TRAP5b)水平高于对照组(P<0.05),病例组血清骨钙素(OCN)、Ⅰ型原胶原N-端前肽(PⅠNP)水平低于对照组(P<0.05)。两组血清中钙、磷、甲状旁腺激素水平比较,差异无统计学意义(P>0.05)。OCN和PⅠNP水平与心脑血管疾病发生风险呈负相关,血清中25-(OH)D_(3)、β-CTX和TRAP5b水平与心脑血管疾病发生风险呈正相关(P<0.05)。甲状旁腺激素水平与心脑血管疾病发生无相关性(P>0.05)。多因素logistic回归分析结果显示,OCN(OR=0.41,95%CI:0.29~0.82)、PⅠNP(OR=0.36,95%CI:0.21~0.72)、β-CTX(OR=5.65,95%CI:3.23~6.67)、TRAP5b(OR=2.59,95%CI:2.35~3.22)、25-(OH)D_(3)(OR=1.16,95%CI:1.09~2.25)、TG(OR=1.34,95%CI:1.21~2.57)、TC(OR=2.13,95%CI:1.91~2.95)、LDL-C(OR=1.79,95%CI:1.61~2.84)、HDL-C(OR=0.33,95%CI:0.23~0.61)水平是老年CKD患者发生心脑血管疾病的影响因素(P<0.05)。结论 CKD患者骨代谢指标与心脑血管疾病发生有密切�Objective To analyze the correlation between bone metabolism indexes and cardiovascular and cerebrovascular diseases in patients with chronic kidney disease(CKD),and to provide a new means to reduce the incidence of cardiovascular and cerebrovascular diseases.Methods A total of 160 elderly patients with CKD who were hospitalized in Department of Geriatric,Cangzhou People's Hospital,Hebei Province from October 2022 to April 2023 were collected as the study objects.They were divided into the control group(80 cases without cardiovascular and cerebrovascular diseases) and the case group(80 cases with cardiovascular and cerebrovascular diseases) according to whether complicated with cardiovascular and cerebrovascular diseases.The clinical data of the two groups were compared,the correlation between bone metabolism indexes and cardiovascular and cerebrovascular diseases was analyzed by Pearson,and the influencing factors of cardiovascular and cerebrovascular diseases in elderly patients with CKD were analyzed by multivariate logistic regression analysis.Results There were no significant differences in age,sex,body mass index,CKD stage,and CKD course between the two groups(P>0.05).The proportion of patients who had smoked or were drinking alcohol in the case group was higher than that in the control group,the levels of triglyceride(TG),total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) in the case group were higher than those in the control group(P<0.05),and the levels of high density lipoprotein cholesterol(HDL-C) in the case group were lower than those in the control group(P<0.05).Serum levels of 25-hydroxyvitamin D_3( 25-[OH] D_3),β-C-terminal telopeptide of type Ⅰ collagen(β-CTX),and tartrate-resistant acid phosphatase 5b(TRAP5b) in the case group were higher than those in the control group(P<0.05).Serum levels of osteocalcin(OCN) and procollagen Ⅰ N-terminal propeptide(PⅠNP) in the case group were significantly lower than those in the control group(P<0.05).There were no significant differe

关 键 词：慢性肾疾病 骨代谢标志物 心脑血管疾病 

分 类 号：R692[医药卫生—泌尿科学]